Komori Takashi
Department of Laboratory Medicine and Pathology (Neuropathology), Tokyo Metropolitan Neurological Hospital.
Neurol Med Chir (Tokyo). 2017 Jul 15;57(7):301-311. doi: 10.2176/nmc.ra.2017-0010. Epub 2017 Jun 8.
The updated 2016 edition of the World Health Organization (WHO) Classification of Tumours of the Central Nervous System (CNS) uses molecular parameters and the histology to define the main tumor categories for the first time. This represents a shift from the traditional principle of using neuropathological diagnoses, which are primarily based on the microscopic features, to using molecularly-oriented diagnoses. Major restructuring was made with regard to diffuse gliomas, medulloblastomas and other embryonal tumors. New entities that are defined by both the histological and molecular features include glioblastoma, isocitrate dehydrogenase (IDH)-wildtype and glioblastoma, IDH-mutant; diffuse midline glioma, H3 K27M-mutant; RELA fusion-positive ependymoma; medulloblastoma, wingless (WNT)-activated and medulloblastoma, sonic hedgehog (SHH)-activated; and embryonal tumor with multilayered rosettes, C19MC-altered. In addition, some entities that are no longer diagnostically relevant-such as CNS-primitive neuroectodermal tumor-have been deleted from this updated edition. The WHO2016 certainly facilitates clinical and basic research to improve the diagnosis of brain tumors and patient care.
2016年更新版的世界卫生组织(WHO)中枢神经系统(CNS)肿瘤分类首次使用分子参数和组织学来定义主要肿瘤类别。这代表了从传统的主要基于微观特征的神经病理学诊断原则向使用分子导向诊断的转变。在弥漫性胶质瘤、髓母细胞瘤和其他胚胎性肿瘤方面进行了重大调整。由组织学和分子特征共同定义的新实体包括胶质母细胞瘤、异柠檬酸脱氢酶(IDH)野生型和胶质母细胞瘤、IDH突变型;弥漫性中线胶质瘤、H3 K27M突变型;RELA融合阳性室管膜瘤;髓母细胞瘤、无翅型(WNT)激活型和髓母细胞瘤、音猬因子(SHH)激活型;以及具有多层玫瑰花结的胚胎性肿瘤、C19MC改变型。此外,一些不再具有诊断相关性的实体,如中枢神经系统原始神经外胚层肿瘤,已从该更新版中删除。《WHO2016》无疑有助于临床和基础研究,以改善脑肿瘤的诊断和患者护理。